Symptoms & Conditions

Spinal Surgeon in Liverpool

COMMON SYMPTOMS

Acute Lower Back Pain

Acute low back pain is a pain in the lower back that has lasted for less than six weeks. The discomfort can take the form of jabbing, stabbing or burning and can be a dull ache or a sharp pain. The pain may occur after a particularly vigorous exercise or may arise slowly over the course of a few months. Acute low back pain is rather common and around 80% of people experience this pain in their life.

Identifying what caused the acute low back pain can sometimes be challenging. Acute low back pain can develop over time in the lower back through normal wear and tear. The pain can originate from muscles, ligaments, connective tissue, joint capsules, cartilage that are sprained, stretched or pulled. This may be a result of poor posture, incorrect lifting technique or twisting clumsily. Nerve root syndromes can produce symptoms of nerve impingement otherwise known as sciatica – this is typically from a disc herniation, also known as bulging or a slipped disc.

One of the best ways to treat acute low back pain is through gentle exercises, stretching and a continuing of regular activities. Keeping the body active allows blood and nutrients to continue following to the back, reducing muscular tension and discouraging inflammation.

Alternatively, anti-inflammatory drugs (NSAIDs) and analgesics (pain killers) may help to reduce acute low back pain and reduce inflammation. Muscle relaxants and narcotics are stronger options, which should always be used under the supervision of a prescribing doctor.

Chronic Lower Back Pain

Low back pain is considered chronic if it lasts longer than three months, the cause of which may be from an injury, disease or continued stress on different parts of the body. The pain may rise as a burning, stabbing or an ache and can take the form of a bone, nerve or muscle pain.

Chronic lower back pain can arise from a number of potential afflictions. The cause could be a structural or mechanical problem like degenerative scoliosis, spondylolisthesis, degenerative disc disease and iatrogenic flat-back deformity or others.

However, a specific cause of chronic back pain is not always possible to identify.

There are a number of treatments available for chronic low back pain. These include physical therapy, medications, coping skills and alternative medical treatments.

Physical therapy includes physical education and is designed to increase the patient’s core strength through continued movement. A range of medications, narcotic and non-narcotic may also be prescribed. Additionally, coping skills may be learnt which are beneficial in dealing with the depression and anxiety, which can result from, prolonged back pain.

Surgery could be considered usually when lower back pain is associated with neurological symptoms and when conservative methods of treatment have failed to improve symptoms.

Sacro-iliac (SI) Joint Pain

The sacroiliac (SI) joint connects the sacrum (bottom portion of the spine) to the pelvis. This structure acts as a shock absorber for any stresses moving from the back to the pelvis. The pain presents as low back pain localized to one or both sides. It can also cause pain into the buttocks, pelvis, groin or even mimic "sciatic" pain shooting down the back of the leg.

Common symptoms of Sacro-iliac dysfunction include:

Lower back pain (below L5)

Sensation in lower extremity: pain, numbness, tingling, weakness

Pelvis/buttock pain

Hip/groin pain

Feeling of leg instability (buckling, giving way)

Disturbed sleep patterns due to pain

Disturbed sitting patterns (unable to sit for long periods, sitting on one side)

Pain going from sitting to standing

Chronic SI joint pain symptoms can make it difficult to perform common daily tasks and can affect every aspect of a patient's life. It often hurts to sit or stand for long periods with weight shifted to the affected side, and sleeping on the involved side can be painful as well.

It is generally agreed that pain in the SI joint is created through vigorous movement or stress through the joint. This pain can be caused by a traumatic event or through degeneration over time.

It is important to identify if pain in the back originates from the SI joint. The diagnosis is most of the times clinical through diagnostic manoeuvres. Imaging studies are always helpful to exclude the presence of infection (sacro-ileitis). An injection of local anesthetic into the SI joint can also help in discovering the source of the pain. If the SI joint is found to be the source of the discomfort, ice, anti-inflammatories and physical therapy (core stabilization exercise program) are normally prescribed. Alternatively, a SI injection may be used for pain relief, where a mixture of steroid and numbing medication is injected into the joint. This can help decrease inflammation and reduce pain.

If you are suffering from SI joint pain and you think you need a spinal surgeon in Liverpool, then please get in touch.

Lumbar Radiculopathy (Sciatica)

Lumbar Radiculopathy, otherwise known as Sciatica is a pain, with associated numbness or tingling that frequently travels down the lower back and into the legs and extremities. Sciatica or radiculopathy is the pain caused when a nerve is impinged or irritated, usually by a disc herniation or protrusion that presses directly on the nerve.

Sciatica may occur from trauma to the lumbar spine, arthritis of the lumbar spine or from a degenerative disc disease. Most occurrences of radiculopathy can be treated with pain medication, physiotherapy and steroid injections. The majority of cases resolve with nonoperative treatments but If pain persists surgery may be an option.

Coccydynia

Coccydynia is a pain that occurs at the end of the spine, or the coccyx. If strained or injured this may cause a dull ache with sporadic sharp pains. This can be exacerbated when sitting, standing and using the toilet. Treatment of Coccydynia takes the form of non-steroidal anti-inflammatory painkillers, physiotherapy and injections of anti-inflammatories.

Curved Spine

When viewed from the back, the spine should run straight down the middle of the back. When abnormalities occur, the spine may become misaligned. There are two main disorders. Kyphosis is when a person’s upper back becomes significantly rounded. Scoliosis is where the spine curves to the side.

Neck Pain

There are a number of causes which may contribute to neck pain. Injuries which force unnatural movements in the neck cause tightening and this causes muscle fatigue which results in pain and stiffness. General wear and tear also called degenerative disease or spondylosis, disc herniations, spinal stenosis can also impact on the spine, causing neck pain. Obesity, poor posture and deconditioning can all contribute significantly in causing pain in the neck.

Common treatments for neck pain include medication, physical therapy and alternative medicines. If pain is prolonged and severe, surgery is also an option.

Arm Pain/Numbness/Weakness (or Cervical Radiculopathy)

Arm pain associated with numbness and tingling in the arm, also called cervical radiculopathy, can be caused by a disc herniation at the level of the neck (cervical spine).

Often referred to as a trapped nerve, this is when irritation is caused to one of the nerves in the neck. This frequently causes pain to radiate through the arms and is often accompanied with pins and needles. In severe cases the arm can become weak. The pain usually travels in a specific (dermatomal) distribution specific for each affected nerve. Local inflammation around the affected nerve can usually increase the pain levels.

Pain generally subsides after three months; during this period anti-inflammatory medication can be used to treat any pain. In case pain persists a selective nerve root injection or surgery can be considered.

Hand/Fingers Numbness

Numbness in the hands can arise from nerve compression at the neck level but also from peripheral nerve compression at the level of the elbow (cubital tunnel syndrome) or wrist (carpal tunnel syndrome).

If you are experiencing any of the above symptoms, then you may need to speak to a spinal surgeon in Liverpool. Contact my spinal surgery and I would be happy to speak to you.

Treatments

CT Guided Coccyx Injections
Coccygectomy

Treatments

Treatments

SPINAL CONDITIONS

Lumbar Spine

Lumbar Disc Herniation (Slipped Disc)

A slipped or herniated disc occurs when the inner portion of the discs that cushion the vertebrae in the spine, protrude out through the outer ring of the discs. Herniated discs are most common in young to middle-aged adults. Symptoms of a herniated disc usually include pain that travels into one or both legs, often associated with numbness or tingling, muscle weakness. The pain which occurs when the disc presses on the nerves is called sciatica. Sciatica typically starts from the back, and radiates to the buttocks and legs.

Treatment is usually in the form of painkillers physiotherapy and short period of rest.

Surgery is usually indicated when nonoperative treatments failed to improve symptoms.

Cauda Equina Syndrome (CES)

Cauda Equina Syndrome is a rare pathology that requires urgent treatment. It is usually caused by a large disc herniation causing significant narrowing of the spinal canal (stenosis) and less frequently by a spinal tumour. Equina Syndrome usually presents itself with severe low back pain, leg pain and weakness in one or both legs, with associated bladder, bowel and sexual dysfunction.

The treatment of choice in case of CES is emergency surgical treatment to relieve pressure to the nerves in order to prevent permanent damage to the legs, bladder and bowels.

Lumbar Spinal Stenosis (LSS)

Lumbar Spinal Stenosis generally occurs from degenerative conditions such as osteoarthritis and/or degenerative spondylolisthesis and typically affects patients over 50s. In these patients, stenosis is the result of aging and “wear and tear” on the spine. Patients with lumbar spinal stenosis typically develop “neurogenic claudication” symptoms which consist of pain, tingling, or cramping in the lower back and one or both legs, hips, and buttocks. Weakness or heaviness in the legs may also occur.

Symptoms often increase when walking and decrease when the patient sits, bends forward or lies down.

Lumbar Spine MRI is the best diagnostic imaging test for lumbar spinal stenosis as this test gives a three-dimensional view of the spinal canal, nerve roots, and surrounding tissues.

Non-operative treatments of LSS may include:

Non-steroidal anti-inflammatory drugs (NSAIDs)

Massage, Heat

Physical therapy, Acupuncture

Epidural or Nerve Root Spinal injections

Degenerative Disc Disease (DDD)

When the discs between vertebrae degenerate, the discs dry and lose their integrity. Typically afflicting older people but this condition can start in young age. It can also be caused by wear and tear from sports and daily activities. Symptoms are many and can take the form of a nagging pain that affects the low back, buttocks or thighs, numbness in the extremities, pain exacerbated by bending and lifting. Treating this condition can be through physical therapy, non-steroidal anti-inflammatory drugs or surgery.

Spondylolysis

Spondylosis is when the vertebrae at the base of the spine are fractured. It frequently happens to adolescents and young adults who engage in sports or other strenuous activity. The pain may take the form of a strained back or pain in the legs and buttocks. Treatment is usually non-surgical and heals with rest, physical therapy and a program of core strengthening.

Visit the British Scoliosis Society website to learn more about spondylolysis -

Sacro-iliac Joint Dysfunction

If the patient is suffering from lower back pain, sciatic like pain, stiffness or instability this can originate from Sacro-iliac Joint Dysfunction. A number of factors can cause this dysfunction including gait issues, pregnancy, previous lower back surgery and activities that place constant stress on the SI joint. To treat the dysfunction, rest, medication, braces, physical therapy and joint injections can help to alleviate the pain.

If initial treatment fails, or the amount of pain relief does not persist, and there is a high degree of certainty that the SI joint is the case of the pain, then the patient may undergo a Sacro-iliac Joint (SI) Fusion. This is involves fixing the sacrum to the ilium using 2 or 3 metal implants joint to stop any movement.

Adult Spinal Deformity

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it. The term is derived from the Greek language: spondylos means vertebra and listhesis means to slip. There are several types or causes of spondylolisthesis;

Congenital spondylolisthesis means the disorder is present at birth.

Isthmic spondylolisthesis occurs at a young age when a defect, such as a fracture occurs (spondylolysis) and then one vertebra slips over the other.

Degenerative spondylolisthesis is more common in older age and is often associated with degenerative disc disease.

Physical therapy is generally used to treat the condition. Surgical fusion may be attempted if the damage is particularly severe.

Visit the British Scoliosis website to know more about spondylolisthesis

Scoliosis

When a spine curves to the side, this can be a symptom of scoliosis. It typically afflicts children and adolescents. Additional symptoms include uneven shoulders, leaning to one side, one shoulder or hip sticking out and a visibly curved spine. Occasionally treatment is unnecessary and the curve may improve over time. Otherwise a brace can be worn to control the curve. When growth stops, an operation may straighten the spine. In adults (Adult Idiopathic Scoliosis), painkillers, spinal injections and occasionally surgery are used to control the curvature.

Scheuermann`s Kyphosis

Kyphosis can be found when the back is significantly rounded, by more than 50 degrees. This can be caused by poor posture, arthritis, osteoporosis, abnormal vertebrae, tumours and infections or spina bifida. The symptoms of this condition are tiredness in the back or legs, a hump or severe curve to the back or a bending forward of the head. To correct the curvature, treatment can be in the form of a brace, anti-inflammatory medicine or surgery.

Sagittal Imbalance

Sagittal imbalance occurs when there is a disparity in the front and back of the spine. The lumbar spine has an inward curve whilst the thoracic spine has an outward curve and these generally work in unison. Loss of the lumbar lordosis is the main driver of sagittal deformity. This can result in low back pain, difficulty walking and muscle fatigue. Sagittal imbalance is typically associated with significant disability.

There are a number of reasons for the imbalance so treatment is generally on a case to case basis, but frequently takes the form of surgery.

Need a consultation with a professional spinal surgeon in Liverpool? Get in touch with me to schedule yours today.

Neck-Cervical Spine

Cervical Disc Herniation

In this condition, the inner core of a disc in the neck, leaks out of the disc and presses onto a nerve. This generally occurs after the age of 30 and can arise suddenly or when there is a trauma. Pain may feel dull or sharp in the neck, between the shoulder blades, and may radiate (travel) downward into the arms, hands and fingers and can associated with numbness and tingling.

Treatment can take the form of physical therapy, chiropractor therapy and injections amongst other things. If the pain lasts longer than three months, surgery is also an option.

Cervical Spondylotic Myelopathy

Typically affecting over 50s, Cervical Spondylotic Myelopathy is a condition where the spinal cord becomes constricted due to normal wear and tear as we age. The condition can also result from severe injury, rheumatoid arthritis bone spurs or an herniated disc. Common symptoms include neck pain, arm numbness and weakness, loss of balance, falls and dexterity problems. The natural history of cervical spondylotic myelopathy has shown that this condition usually slowly deteriorates with time. In this case the condition closely monitored. Treatment can include physical therapy, non-steroidal anti-inflammatory medication use of a cervical collar short term. In cases of rapid deterioration of myelopathy surgery is indicated.

Osteoporosis

Osteoporotic Spinal Fractures

Osteoporosis is a serious disease that reduces the strength of the vertebrae, making them more likely to break. These breakages (fractures) can cause severe back pain. Patients develop stooped posture, loss of height and difficulty in walking, twisting and bending. Fractures typically occur in women, especially those over 50. The best course of action is generally to prevent future fractures with medication to strengthen bones in the body.

For more information, please contact me at my spinal surgery in Liverpool.

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This is the Symptoms & Conditions webpage of https://www.balancedspine.co.uk.
It has been created by Prokopis Annis - Balanced Spine Do you have lower back pain or numbness in your hands? These symptoms could indicate underlying spinal conditions. At Balanced Spine Surgery my aim is to restore equilibrium to patients' spines and raise the quality of life. Read on here about the various spinal symptoms and conditions. service and
We hope that this webpage provides you with lots of useful information.
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